Post acute care staffing ratio

Nurses General Nursing

Published

Specializes in emergency, trauma, psychiatry.

what are your ratios?

in "my" facility I medicate 19 patients, IV, 2 trach PT, lots of pain meds, asthma treatments, paper documentation and paper orders (!!!!).

on the unit, day tour, there are typically total 3 RNs/Lpn - one charge ( who helps with treatments if not too busy with admissions/discharges) and 2 med nurses. I often pass 10 am meds from before 9am to 1 pm.

is it legal? what can I do ( besides quitting?)

my DON told me today that she is covered and 19 medicating 19 patients is normal in Nursing Homes

Is it?

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Nope, medicating 19 patients is *not* normal in a nursing home setting. That's actually far *fewer* people to medicate than your average med pass.

Medicating 25-30 is far more common. And if you were on a LTC wing, those number creep closer to 40.

And having a charge who doesn't have a med pass of her own, and is willing to help on the floor, is rare as well. You're facility has above average staffing, even for a subacute unit, and there's definitely nothing illegal in what you described.

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Specializes in emergency, trauma, psychiatry.

How is it possible to give

meds to 40 people all scheduled for 10 am within the required 2 h window?

When someone shows you who they are, believe them the first time.Maya Angelou

Read more at When someone shows you who they are, believe them the first time. - Maya Angelou at BrainyQuote

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

It sounds as if you work in the subacute rehab wing of a nursing home or a short-term post-acute Medicare unit in an LTC/SNF facility.

What you describe is normal and legal. California is the only state that has legally mandated nurse/patient ratios, and these laws only apply to acute care hospitals, not post-acute settings such as subacute rehab, LTC and SNF.

The other 49 states have no legally mandated nurse/patient ratios.

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How is it possible to give

meds to 40 people all scheduled for 10 am within the required 2 h window?

When someone shows you who they are, believe them the first time.Maya Angelou

Read more at When someone shows you who they are, believe them the first time. - Maya Angelou at BrainyQuote

40 is at the higher end of the range, but it is not at all unheard of. It is doable if you are organized and if distractions are minimized, ie your CNAs know not to bother you unless it is truly urgent.

And, again, 40-person-med pass is more likely in a LTC setting. LTC is different from where you are working. From what I gather, you're in a subacute (or post-acute, as you call it) where acuity is higher.

The subacute units at my facility have about that level of staffing, and patients there have wound vacs, central lines, even TPN. I know it seems hard to believe, but 19 patients in a subacute, nursing home setting is considered good staffing. one would wish for fewer patients, of course, but wish in one hand and poop in the other, guess which one fills up first?....

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Specializes in emergency, trauma, psychiatry.

Thank You everyone for input, I guess I didn't know where I stepped in :(

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